Welcome to HIV Weekly, a weekly email bulletin that provides people with, or affected by, HIV a concise, plain English digest of a selection of the very latest HIV news.

This new digest puts the latest HIV news stories into their context to equip you with the knowledge to understand what the latest research might mean for your HIV treatment and care.

Information on the latest NAM treatment information resources and those produced by other key organisations such as the UK Coalition and THT are also included.

HIV Weekly is edited by Michael Carter, NAM's patient information and news editor.

An HIV Weekly archive will be provided online.

There are four main sections to this edition of HIV Weekly:

• HIV and hepatitis: More news from a recent conference on HIV and hepatitis coinfection in Amsterdam, plus a hepatitis C protease inhibitor makes good progress in clinical trials and a study suggests that a blood test used to monitor the health of the liver may not always pick up evidence of liver damage.

• Side-effects: Interactions between anti-HIV drugs could be the cause of the kidney problems that a small number of people taking tenofovir (Viread) experience.

• Lipodystrophy: The risk of developing increased levels of blood fats during treatment with a protease inhibitor is different for different racial groups, American researchers have found.

• New drugs: Most maraviroc studies to continue.

HIV and hepatitis

First of all, I think I need to explain why, for the third week running, there is more news on HIV and hepatitis in HIV Weekly than any other subject.

Liver disease caused by hepatitis B or hepatitis C has become a major cause of illness and even death in HIV-positive people since effective anti-HIV treatment became available. Coinfection with HIV and hepatitis B or hepatitis C can make it harder to treat both HIV and hepatitis.

Because of the growing importance of hepatitis to the treatment of HIV an increasing amount of research is being devoted to the subject. Some HIV doctors have become particularly skilled at treating HIV and hepatitis coinfection and an international workshop was held in Amsterdam in mid-January where experts from around the world shared their experience and presented their research concerning HIV and hepatitis coinfection.

Another indication of how important hepatitis B and hepatitis C now are is the amount of articles on the subject of HIV and hepatitis coinfection that appear in the major medical journals such as AIDS , the Journal of Acquired Immune Deficiency Syndromes , Clinical Infectious Diseases , and the Journal of Infectious Diseases .

Last week, four pieces of important research looking at the diagnosis and treatment of hepatitis B or hepatitis C were reported on http://www.aidsmap.com/ .

HIV and hepatitis resources on aidsmap.com

There are introductory factsheets on the liver, liver function tests, hepatitis B and hepatitis C.

Living with HIV contains useful information on hepatitis including a first hand account of life with HIV, hepatitis C and haemophilia.

If you would like more detailed information, then the information booklet, HIV and hepatitis should prove useful.

For very detailed information, consult the hepatitis B and hepatitis C entries in the Treatment and Care section.

Side-effects

All medicines cause side-effects and anti-HIV drugs are no exception.

Soon after it was formally approved for use, there were reports that the drug tenofovir (Viread) was causing kidney problems in a small number of people.

Some American doctors recently looked in detail at some of these reports and suggested that the reason for these kidney problems could be interactions between tenofovir and other drugs used to treat HIV.

They looked at a total of 27 cases and found that in 21, the person was taking either the protease inhibitor Kaletra (lopinavir/ritonavir) or ritonavir (Norvir) by itself. In addition, nine people were taking nucleoside reverse transcriptase inhibitor ddI (Videx) and five were taking the protease inhibitor atazanavir (Reyataz).

The doctors suggested that ritonavir might increase concentrations of tenofovir in the kidneys. It is already well known that ddI can increase blood levels of tenofovir in the blood and kidneys and atazanavir can increase tenofovir levels too.

People who take tenofovir with ritonavir, ddI or atazanavir should be closely monitored for evidence of kidney problems, the doctors recommend. This monitoring should include kidney function tests every two weeks during the first two months of treatment.

Lipodystrophy

Anti-HIV drugs can cause a set of side-effects known as lipodystrophy. This can include changes in body fat shape (most notably facial wasting) and increased levels of blood fats (such as cholesterol).

Not all patients develop these side-effects and even when they do occur, their severity can vary between different groups of patients.

American researchers have found that the risk of developing changes in blood fats in people taking protease inhibitors differs according to race.

They found that black patients had lower increases in triglyceride levels and higher levels of ‘good’ HDL cholesterol and lower levels of ‘bad’ LDL cholesterol, suggesting that they had a lower long-term risk of heart disease than either white or Hispanic patients.

The gene apoC-III was found to be associated with smaller increases in triglyceride levels in Hispanic people.

New drug

Maraviroc is being investigated in clinical trials to see if it is a safe and effective for the treatment of HIV. It belongs to a new class of drugs called CCR5 inhibitors. 

In late 2005 a case of severe liver toxicity was seen in a woman who had not previously taken anti-HIV drugs and who was enrolled in one of the maraviroc trials. It is thought that this was due to other drugs the woman was taking.

The independent Drug Safety and Monitoring Board recently met and concluded that most of the studies into the safety and effectiveness of maraviroc should be allowed to continue.

However, they recommended that a study arm looking at once-daily use of the drug by people who had never taken anti-HIV treatment before should be stopped.